Do you know what to do??Presented by APS HealthcareSouthwestern Pa Health Care

Quality UnitHCQU2-27-2004

“Information or education provided by the HCQU is not intended to replace medical advice from the consumer’s personal care physician, existing facility policy or federal,

state and local regulations/codes within the agency jurisdiction. The information provided is not all inclusive of

the topic presented.”

“Certificates for training hours will only be awarded to those who attend a training in its entirety.Attendees are responsible

for submitting paperwork to their respective agencies.”

• List four types of emergencies.• Name two symptoms of a heart

attack.• Name two medical conditions

related to temperature extremes.• State one reason when seizures

would require emergency treatment.

• State three pieces of information you will need when calling 911.

• State four tips to expedite treatment in an emergency situation.

• List two impairments that could be observed in an individual with a head injury and/or spinal injury.

An emergency occurs every second!!

Types of emergencies

• Falls• Heart problems• Car accidents• Choking/foreign

bodies• Uncontrolled

bleeding

• Temperature changes

• Allergic responses• Burns• Seizures• Fire• Shortness of

breath• Head & Spinal

Injuries

Falls

• 2nd leading cause of work related deaths.

• 1800 deaths per year in U.S. nursing homes.

• In 2001, 11,600 people over 65 died from fall related injuries.

• Leading cause of traumatic brain injury (TBI)

Heart problems

• Chest pain– With or without shortness of

breath

• Swelling of legs • Pain in left arm and/or jaw• Sweating• Pale skin

Signs of heart attack

• Chest pain or discomfort lasting longer than 3-5 minutes

• Pain that radiates to the jaw, neck,shoulder or either arm

• Nausea• Skin appearance, which may be pale or

bluish in color• Face is moist or may be sweating

profusely• Unconscious

Car accidents

• As a driver or passenger in a vehicle.– Car vs. car– Car vs. object

• Pedestrian– Car vs. person

Tips for car accidents

• If involved, stay in vehicle until help arrives.

• Not involved, call for help and wait at the scene until help arrives.– May need to follow instructions

given by the emergency dispatcher.• If unsure ask for clarification.

Choking/foreign bodies

• Swallowed objects especially large or ones that are sharp can cause choking.– Rocks– Bones-especially chicken

• Swallowed object that may cause poisoning– Antifreeze– Gas– Household cleaning agents

Choking/foreign bodies cont.

• Inhaled objects can slip by protective mechanisms and cause choking and difficulty breathing– Coins– Balloons– Food-especially not thoroughly chewed

• If a person has a foreign body stuck in their body, leave in place until emergency treatment is sought.– Knife– Pencil– Glass

Uncontrolled bleeding

• Bleeding that cannot be stopped with direct pressure for 5 minutes.

• Any condition in which the bleeding can not be controlled.

• Spraying of blood from the site• Bleeding involving a large

volume of blood.

Temperature changes

• Hypothermia

• Hyperthermia

Hypothermia

• Prevention is the key for reducing chances of hypothermia.– Adequate heat in the home– Staying warm

•Wearing appropriate clothing

– Prepared for power outages– Frost bite can occur within minutes.

Hyperthermia

• Prevention is the key • 2 types of heat related

illnesses– Heat Stroke– Heat Exhaustion

Tips for reducing chances for heat related illnesses

• Increase fluid consumption, if not on fluid restrictions– Avoiding the following drinks

•Alcoholic•Caffeniated•Containing large amounts sugar•Very cold – can cause stomach

cramping

More tips

• Stay indoors and in an air conditioned place, if possible– May have to go to a public place

if you do not have air conditioning.

• Fans can help but only if the temperature is below mid 90’s.

• Take a cool shower or bath.

Tips if you have to be out in the heat

• Try to perform the activities in the early morning or evening hours.

• Cut down on exercise – If exercising, drink additional fluids

• Take frequent rest periods in the shade

• Wear a hat• Sunscreen

– SPF 15 or higher

More tips if you have to be in the heat

• Wear light weight, light colored clothing– Dark colors attract the heat.– Light colors repel the heat.

• NEVER leave anyone in the car for any period of time, this includes pets !!!

Individuals at high risk for heat related illnesses

• Infants and young children• Age 65 and over• Diagnosis of a mental illness• Individuals with a physical

illness– Heart disease– High blood pressure– Kidney disease

Heat exhaustion

• Caused by heat exposure for several days

• Inadequate or unbalanced fluid replacement.

Warning signs of heat exhaustion

• A lot of sweating

• Pale color• Cramping of the

muscles• Tired• Weak• Dizzy

• Headache• Nausea or

vomiting• Fainting• Skin cool & moist• Pulse fast &

weak• Breathing fast &

shallow

What can I do??

• If symptoms are severe or the person has a history of heart problems or high blood pressure, Seek Emergency Treatment!!

• Help the person cool off– Non-alcoholic beverages– Rest– Cool shower, bath or sponge bath– Air conditioned environment– Lightweight clothing

Heat Stroke

• Body is unable to regulate its temperature

• The temperature rises quickly– 106 or higher within 10-15 minutes

• Sweating mechanisms fail• Body can not effectively cool down• Can cause death or a permanent

disability without treatment

Warning signs of Heat Stroke

• High body temperature

• Skin is hot,dry, & red– No sweating

present

• Rapid, strong pulse

• Dizzy• Nausea• Confused• Unconscious• Headache

What can I do??

• Call for help• Get the person to the shade• Cool with any available method• Monitor temperature• Do not give alcohol• Watch for twitching of muscles and

keep person safe.• If unconsciousness, do not give fluids

and watch for vomiting.

Allergic response

• Swelling especially the eyes,tongue, or face

• Difficulty breathing or swallowing• Severe symptoms of asthma• Severe itching• Cramping in the abdomen• Dizziness• Unconscious

Critical burns

• Burns that cause breathing difficulties.– Chemical ingestion or inhalation of

vapors

• Burns covering more than one part of the body.– Arm and hand

• Burns that involve the head, neck, hands, feet, or genitals.

Seizure

• First seizure• If the person is unconscious• Seizure lasts longer than 5

minutes• Repeated seizures• Person is injured• Individual is diabetic• Difficulty breathing

Fire

• Have a planned escape route and practice on a regular basis.

• Never enter a burning building.• Leave the home immediately.• Have a safe place for all members

to meet once out of the house.

Fire continued

• Smoke detectors near sleeping quarters

• Carbon monoxide detectors• Batteries in both and make sure

there is battery backup if they are wired into the home.

• Batteries should be checked every 30 days.

Shortness of breath

• Occurs with wheezing or have a cough.• Occurs with neck stiffness, vomiting,

or light sensitivity.• Occurs after being in very hot

weather.• Occurs suddenly without regard to

activity.– While watching TV.– While sleeping.

Serious Head &/or Spinal Injury

• Look for some of these signs– Change in level of consciousness– Pain or pressure in head, neck, or back– Loss of feeling or sensation in hands,

fingers, feet, or toes– Loss of movement in a body part– Blood or fluid in nose or ears– Heavy bleeding from head, neck, or

back

Serious head &/or spinal injury

• Seizures• Not breathing normally• Changes in vision• Vomiting or nauseated• Headache that will not go away• Balance problems• Any bruising of the head

Serious Head &/or Spinal Injury continued

• When in doubt, especially after a fall or accident.

• Call 911• What information will you need

– Name – Phone number– Address/Directions – Problem/ What happened.– How many are involved.– Other medical conditions.

Other information that needs relayed

• Road conditions– Icy– Not plowed– Flooded

• Live up a lane– Is there any markings at the bottom– Mail box with house number on it???– Road/lane marker???

When you call 911

• Remain calm• Speak slowly and clearly• May have to repeat information • Listen for specific instructions and

ask for clarification if not sure.• After you hang up, keep the line keep the line

clear !!clear !!– Important in case there are questions

or if they can not find the location.

What information is needed for Emergency Personnel

• Time of accident or onset of symptoms

• Age • Medical conditions• Allergies• Family doctor• Current list of medications and

when they were taken last.

Information continued

• Insurance information• Family history• Contact information• Treatments not being followed• Lifestyle

– Smoke– Alcohol consumption– Drug abuse

Tips to expedite treatment when needed

• House numbers– Make sure they are visible from the road.– If you live up a lane,put the numbers at the

end of the lane for a marker.

• Medic alert tags– Helps to quickly identify other medical

conditions that could have caused the problem.

• Emergency personnel look for these as soon as they get on scene.

• Helpful if you are alone and something happens.

More tips

• Knowing clear concise directions to your home– May need someone to help write it

up and keep in a safe place that all members of the family are aware of.

• Calling for help as soon as an emergency occurs.– Death can occur within minutes.

More tips

• Keeping poison control number posted on the refrigerator.

• Reading labels if something was ingested and following the recommendations.

• Labeling poisons and keeping out of reach from children or those who may accidentally consume the product.

More tips

• If you live alone, establish a buddy system so someone either calls or checks in on you everyday.– May invest in an alarm system

• Life alert• Medic alert

• When you have a cold, flu, or anything contagious, staying home and not spreading the disease.

References

• Centers for Disease Control and Prevention,National Center for Environmental Health,(2003,June). Extreme Cold. Retrieved January 22,2004 from http://www.cdc.gov/nceh/hsb/extremcold/

• National Center for Injury Prevention and Control, (2004,January).Falls and Hip Fractures Among Older Adults. Retrieved January 22,2004 from http://www.cdc.gov/ncipc/factsheets/falls.htm

References continued

• Centers for Disease Control and Prevention, National Center for Environmental Health. Extreme Heat. Retrieved January 21,2004 from http://www.cdc.gov/nceh/hsb/extremeheat/Extreme%20Heat%20Complete.pdf

• Some slides were adapted from the HCQU training “When To Seek Emergency Treatment.”

For more information on this or any other physical or behavioral

health topic, please visit our website @ www.hcqu.apshealthcare.com

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